Research Database
Intensive behavioral health intervention for improving health equity in pediatric diabetes
Anthony T, PhD
Institution:
Ann and Robert H. Lurie Children's Hospital of Chicago
Grant Number:
11-21-ICTSHD-49
Type of Grant:
Clinical
Diabetes Type:
Both Type 1 and Type 2 Diabetes
Therapeutic Goal:
Manage Diabetes
Project Date:
-
Project Status:
active

Research Description

Novel Interventions in Children’s Healthcare (NICH) is a behavioral health program targeting health disparities in high-risk youth with diabetes who experience chronically high blood sugars and/or repeated, preventable diabetes hospital admissions. NICH may work by improving social risk factors (e.g., food and housing problems, healthcare access problems) and reducing daily living problems for youth with diabetes and caregivers. However, no scientific studies have examined if NICH improves these concerns. The current study will assess whether NICH affects these important areas, and if improvements in social risk and daily life explain why NICH works to improve medical outcomes. NICH participants will be compared to a similar sample of high-risk youth who never received NICH. Further, the study will determine if a caregiver-reported social risk questionnaire can predict future diabetes medical outcomes. This measure could potentially be used as a clinical tool for providers to make referrals to NICH earlier to prevent diabetes-related challenges. Measures will be collected monthly for a year. Diabetes medical outcomes from medical chart review will include HbA1c (a measure of average blood sugar over time), diabetes-related ED and hospital visits, and outpatient diabetes clinic attendance. Statistical analysis will assess the impact of NICH (compared to a similar high-risk sample without NICH) on reducing social risks and improving daily living. Analyses will also evaluate if these changes then lead to diabetes medical outcome improvements. Another statistical analysis will assess whether the measure of caregiver report on social risk predicts medical outcomes over time to assist with NICH referrals.

Research Profile

What area of diabetes research does your project cover? What role will this particular project play in preventing, treating and/or curing diabetes?

Novel Interventions in Children’s Healthcare (NICH) is a behavioral health program targeting health disparities in high-risk youth with diabetes who experience chronically high blood sugars and/or repeated, preventable diabetes hospital admissions. NICH may work by improving social risk factors (e.g., food, housing, and healthcare access problems) and reducing daily living problems for youth with diabetes and caregivers. However, no scientific studies have examined if NICH improves these concerns. This research project will assess whether NICH affects these important areas, and if improvements in social risk and daily life explain why NICH works to improve medical outcomes like glycemic variability and diabetes-related medical visit attendance. This project will contribute to understanding how the NICH intervention assists families in removing medical care access barriers and improving daily functioning which ultimately improves medical outcomes and quality of life for youth and families living with diabetes.

If a person with diabetes were to ask you how your project will help them in the future, how would you respond?

The overall findings of this project will allow us to provide further support of the positive influence of the NICH program and ultimately assist us with being able to more broadly disseminate and implement this program in areas where it does not currently exist. We are also hoping that by providing more support for NICH's treatment efficacy that insurance payors may be more willing to cover the intensive behavioral interventions essential to NICH. While this project may help some people who are struggling with the daily management demands of diabetes more immediately, it may not benefit every individual; however, the broad impact of the findings may contribute to our understanding of how to reduce negative social influencers of health and promote health equity within the diabetes community.

Why important for you, personally, to become involved in diabetes research? What role will this award play?

As a pediatric psychologist working at a major medical center, I constantly see the impacts that diabetes and adverse social stressors have on youth with diabetes and their families. There are many times when our interventions are simply not enough, particularly for youth exposed to traumatic life events or living in under-resourced communities. Being able to contribute to conducting research that will support more intensive behavioral services and that may relieve many of the common barriers that I see with my families is highly rewarding to me. This project will allow us to discover how a program like NICH makes its treatment impact. I have previously published on the naturalistic impacts of diabetes-related distress and anxiety on medical outcomes in the context of diabetes. This project will move my research into the intervention arena where I can begin to think more about how we can refine treatment practices and learn how to further support youth and families experiencing challenges in daily management of diabetes.

In what direction do you see the future of diabetes research going?

Many psychological and behavioral health interventions have been developed and well-researched to treat depression, anxiety, and other disorders in children, adolescents, and adults. There have also been interventions to target diabetes distress and modifications to existing behavioral health interventions have been made to be specific to the experiences of people living with diabetes. I see future diabetes research to be focused on building capacity to implement and disseminate these interventions. I also see a necessity in future diabetes research to include metrics that tap into the psychological and lived experiences of people with diabetes across all studies focused on preventing, treating, and curing diabetes. The information gained from these data will promote the effectiveness and delivery of any interventions developed from these studies.